Gut-lung crosstalk during critical illness

Area of Science:

• Microbiology
• Pulmonology
• Critical Care Medicine

Background:

• Organ crosstalk is crucial in critical illness, but the microbiota's role, particularly the gut-lung axis, is understudied.
• The gut microbiome, the body's largest microbial biomass, can impact lung physiology during critical illness.

Approach:

• Reviewing emerging evidence on the gut-lung axis in critical illness.
• Examining mechanisms of gut-to-lung communication, including microbial translocation and metabolite signaling.
• Highlighting clinical examples and therapeutic potential.

Key Points:

• Gut dysbiosis (pathobiome) disrupts gut barrier function, enabling microbial translocation to the lungs.
• Gut microbiota influence lung physiology through secreted metabolites and host-derived messengers.
• Selective digestive tract decontamination demonstrates therapeutic potential for the gut-lung axis.

Conclusions:

• The gut-lung axis is pathophysiologically relevant in critical illness.
• Further research is needed to understand the therapeutic and prognostic implications of the gut microbiome in critical illness.